Agenda item

(To consider a report from Greg Rielly, Inspection Manager, Adult Social Care Directorate, Care Quality Commission – the national regulator of health and social care services.  The report provides an overview for the Committee on the Care Quality Commission's activities in relation to adult social care services in Lincolnshire, where the Commission is the regulator)

The Committee considered a report from the Care Quality Commission (CQC), which provided a position statement on the progress and themes coming out of the CQC's inspections of Adult Social Care services in Lincolnshire.

It had been highlighted in the report that the CQC was not subject to local authority scrutiny and the relationship was an informal one based on an understanding, trust and joint aspiration to improve services.

Greg Rielly, the CQC's Inspection Manager for Lincolnshire reported that since the last attendance at Adults Scrutiny Committee, the CQC's inspection methodology had changed and become more intrusive, including the inspection of hospital providers.

The ratings given to establishments after inspection were Inadequate, Requires Improvement, Good and Outstanding.  In Lincolnshire 78% of establishments were rated as Good, with 21% as Requires Improvement and Inadequate and Outstanding at 1% each.

The CQC had recently put a new structure in place for regulatory breaches, so that if a provider was rated as Requires Improvement three times in a row, they would be struck off.

Of the individual criteria that had to be met during an inspection, Safe and Well Led seemed to be the hardest to meet.  Also, on 1 November, a new criterion How Caring? would be introduced.

There was discussion regarding the workforce of each provider and the CQC's requirement for each to have a Registered Manager.  There were currently 23 locations in Lincolnshire without a Registered Manager and failure to register a manager within 12 weeks could result in criminal enforcement and potentially a fine of £4,000 minimum.

Members sought clarification on the process to register a manager and it was explained that the process could take up to six weeks, following which there was every possibility that the registration could be refused on various grounds.  In addition to this, managers sometimes left the provider, whilst registration was in progress.

It was felt by some Councillors that failing to register or retain a manager was a vicious circle for providers.  Special measures and penalties for not having one in place did not come with extra funding or support to help secure and retain one.

There was a question regarding the 82% of adult social care services originally rated as inadequate, which improved their rating following a re-inspection.  Officers explained that the County Council undertook an interim site visit in between the CQC inspections, where they had a contract.  If a provider was causing considerable concern, the Council would visit on a monthly basis.  Low risk providers, performing well, qualified for an annual visit.  There had also been additional inspections focussing on a particular issue, if the need arose.  The CQC and the County Council continually communicated to share knowledge.

Officers reported that in Lincolnshire, most providers were small to medium enterprises, for which keeping on top of inspections from CQC, LCC and the NHS was not an easy job.  Melanie Weatherley, the Chair of the Lincolnshire Care Association (LinCA) could offer support and help to providers if needed, on any aspect of the inspection process.

RESOLVED

That the information presented on the themes arising from the CQC's inspections of Adult Social Care services in Lincolnshire to date, be noted.